More Than One Way to Change: A Study of Course Heterogeneity During and After Short‐term Psychiatric In‐patient Treatment

This study describes differences in course and outcome, defined by GSI (SCL‐90) at admission, discharge, and one‐year follow‐up, in 458 patients receiving in‐patient treatment for long‐standing symptom and/or personality disorders. A K‐mean cluster analysis identified seven subgroups of patients, representing four clinical distinct, meaningful patterns of change: early improvement, late improvement, relapsing after discharge, and a severe chronic course. Main findings: the subgroups had unique correlates among socio‐demographic, diagnostic, and treatment‐related characteristics. One of the relapsing groups had a high rate of Cluster C personality disorders, whereas the other had low participation in the anxiety programme. The group with severe chronic course showed occupational maladjustment and high number of both Axis I and II disorders. Implications: anxiety patients should participate in anxiety‐treatment programmes, Cluster C patients should be followed and monitored for relapse, and severe chronic patients should be offered specialised treatment for their co‐existing substance abuse and/or eating disorders.